Anti-cholinergic Drugs

Question 1

Muscarinic Receptor Blockers

Answer 1

1. Atropine 2. Homoatropine (short-acting prep of atropine) 3. Tropicamide (shortest acting prep of atropine, 4h) 4. Pirenzepine (tx peptic ulcers) 5. Scopolamine (prevents motion sickness) 6. Benztropine (tx druv induced Parkinsons 7. Ipratropium bromide (tx COPD & asthma) 8. Dicyclomide (tx mentral pain & GI spasm)

Question 2

N receptor Blockers

Answer 2

1. Hexamethonium 2. Mecamylamine these competitively block NN receptors

Question 3

Atropine

Answer 3

tertiary amine; enters CNS–>produces long-acting side effects 1. Decreased salivary, bronchial & sweat secretion–>dry mouth 2. mydriasis & cycloplegia–>loss of accommodation reflex 3. tachycardia 4. constipation 5. urinary retention 6. bronchial relaxation 7. excitation/hallucinations OPPOSITE TO DUMBBELSS

Question 4

Tropicamide use

Answer 4

preferred to produce mydriasis & cycloplegia in refraction error testing & fundoscopy bc of 4h DOA

Question 5

Benztropine use

Answer 5

DOC for treatment of drug-induced parkinsonism (tx extrapyramidal symptoms)

Question 6

Ipratripium Bromide use

Answer 6

Tx COPD & Bronchial asthma (not much systemic absorption, so fewer side effects)

Question 7

atropine poisoning effect on eye

Answer 7

1. mydriasis (iris practically obliterated) 2. blurring of near vision 3. dryness of conjunctiva

Question 8

Pirenzepine use

Answer 8

Tx peptic ulcers

Question 9

Scopolamine use

Answer 9

prevent motion sickness (other drugs used to treat motion sickness are antihistamine drugs)

Question 10

Glycopyrrolate use

Answer 10

used in general anesthesia to reduce bronchial secretions

Question 11

dicyclomine use

Answer 11

to treat GI spasm, spasmodic abdominal pain, i.e. menstrual pain (can also be treated using NSAIDS)

Question 12

mydriasis (iris practically obliterated), blurring of near vision, dryness of conjunctiva, difficulty speaking, dyspnea, respiratory depression, dry, hot, red skin, dry mouth, thirst, difficulty swallowing, absence of bowel sounds, paralytic ileum, difficulty in micturition, tachycardia, palpitations, arrhythmias, fatigue, ataxia, headache, restlessness, hallucinations, delirium, generalized convulsions, coma

Answer 12

symptoms of atropine poisoning, aka Anti-DUMBBELSS Atropine = muscarinic receptor blocker

Question 13

atropine poisoning effect on respiratory system

Answer 13

difficulty speaking, dyspnea, respiratory depression

Question 14

atropine poisoning effect on skin

Answer 14

DRY, HOT, RED SKIN

Question 15

atropine poisoning effect on GI system

Answer 15

1. dry mouth 2. thirst 3. difficulty swallowing 4. absence of bowel sounds 5. paralytic ileus

Question 16

atropine poisoning effect on urinary system

Answer 16

difficulty in micturation

Question 17

atropine poisoning effect on CVS

Answer 17

tachycardia, palpitations, arrhythmias

Question 18

atropine poisoning effect on CNS

Answer 18

1. fatigue 2. ataxia 3. headache 4. restlessness 5. hallucinations 6. delirium 7. generalized convulsions 8. coma

Question 19

Atropine uses

Answer 19

1. treat cholinesterase inhibitors/OP poisoning 2. treat poisoning by AChE inhibitors of by certain mushrooms containing muscarine 3. produce mydriases in refraction error testing (short acting preps of atropine are preferred 4. Treat Heart block 5. Treat Bradycardia

Question 20

Hexamethonium, MOA, use

Answer 20

NN blocker, aka ganglion blocker MOA= competitive blockade of NN receptor Use: none due to high toxicity (SEVERE HYPOTENSION)

Question 21

Mecamylamine, MOA, use

Answer 21

NN blocker, aka ganglion blocker MOA= competitive blockade of NN receptor Use: none due to high toxicity (SEVERE HYPOTENSION)